Thursday, May 6, 2010

On Unnatural Childbirth

Four years ago, as I prepared to give birth to our son Daniel, I did what many educated first-time mothers do: I read books on childbirth (and pregnancy and baby care). Lots of them. After reading those books I had a healthy skepticism of what has become the "standard" hospital birth in America. So I made a birth plan, discussed it with my doctor, and prepared myself for the most natural childbirth I thought I could manage short of doing a home birth.

Then about two months before my delivery my doctor unexpectedly left the practice he was in and took several months off work before setting up a new one. I was assigned a new doctor, who was much less on-board with the whole birth-plan idea, and who one day, after I had been dilated past four centimeters for about two weeks, frowned as she listened to my unborn son's heart. She suggested an ultrasound, a non-stress test and some fetal monitoring, then an immediate induction. Nothing super-emergency, but a tired-looking placenta and decelerating heart rate that she didn't want to let go unsupervised over the long Memorial Day weekend. And even though I didn't feel great about the induction, I knew that I would make myself sick for three days wondering if he was wasting away in there, and so I went to the hospital planning to stick to the rest of my birth plan as closely as possible.

After many hours of pitocin-induced contractions, missed meals, and no sleep, I almost kissed the anesthesiologist who put in my epidural. I enjoyed the couple hours of rest I had before all the pushing and pushing that didn't move the baby at all, and then the eventual c-section that finally got that boy out where I could see him. And so I became the poster child for what natural childbirth advocates warn not to do, for the one intervention that leads to another until a full cascade of medical technology was unleashed in my hospital room.

After Daniel's birth I was disappointed. Disappointed that I hadn't followed my plan, that I hadn't boldly refused intervention in favor of a "wait and see" approach like all the books told me I should, and disappointed to have missed what it felt like to actually give birth. Instead I felt like I'd been hit by a truck. But I didn't think too much about it because I had a beautiful, voracious nurser with fabulous APGAR scores and I was just so excited to see him. And that was it; I obsessed over it for a little while afterward, wondering whether something could have been done differently, but in the end I did not feel bitter or sorrowful about Daniel's entry into the world.

Only later did I realize that I was not in The Club. As I met other mothers and talked about birth experiences I started to get a vibe from some women that a person who has a medical birth is foolish or weak or maybe too self-absorbed to have insisted on the very best birth experience for her child. I had several people assume that I must be devastated at the experience of walking out of the hospital with a perfect, healthy child who was born by c-section. I wrote and submitted my birth story for a collection being made by a local nursing support organization, and was stunned to find that it had been placed in the chapter of traumatic births (which included a warning that pregnant women might best avoid reading it until after their deliveries).

At first this bothered me, this feeling that I was somehow not as good as other mothers who had delivered their children vaginally, or that I should be really sad about Daniel's birth. And I thought maybe I could redeem myself with a VBAC (vaginal birth after caesarian). But 18 months later, a new obstetrician completed an exam, reviewed my records, and took a good look at the size of my husband. He said that as much as he knew I wanted a VBAC, he was going to have to recommend a repeat c-section. He reasoned that (because of hospital and anesthesiologist policies in our town) an epidural wouldn't be an option, and he feared my chances of another long, hard labor with a c-section on top might be really good. He encouraged me to get a second opinion, but after going home and giving it a good long think, I never did.

In the end, I decided that for me the stress of whether I'd accomplish the VBAC was worse than the c-section. I didn't want to spend the end of my second pregnancy like the end of my first one, thinking and re-thinking all the possible scenarios, rehearsing all the pain-management positions, and lying awake worrying about whether things would go as I wanted them to. Maybe I'm a perfectionist, and can't stand the thought of doing something I'm not sure will turn out just right. Or maybe I'm lazy and can't live with the chance that I might expend a lot of effort for naught. But I think I realized that I cared more about enjoying welcoming my second child into the world instead of making myself sick over it.

And so, two years ago today I woke up early in the morning, drove calmly to the hospital, checked in, and relaxed in bed listening to my husband read the Longfellow poem Evangeline. At the scheduled time I was wheeled into the operating room and my own beautiful Eva was born. There was no agonizing worry, no yelling, no crying (at least not from stress). I was able to meet and give consent to a number of nursing students who wanted to observe a c-section being performed. I felt really peaceful and calm, and recovered so quickly and easily afterward that I was asking to go home the next morning.

I want to be clear that I am not advocating c-section as the ideal birth method. I would love to have had my children naturally, without medications or bright lights or shiny metal instruments. My neighbor Laurie is a doula, and graciously speaks to my Developmental Psych class each semester about the pros and cons of different birth alternatives. I love to watch the videos she brings of the women giving birth, because of the wonderful look on their faces as they push the baby out and realize what they've accomplished. I am also a reasonable person who is persuaded by research that highlights the benefits of natural childbirth for the mother and the baby. But as Laurie points out each semester, there has to be a good fit between the mother's personality and her support system and her birth method. And I have to admit that as much as I wanted natural childbirth to be a good fit for me, it just wasn't. Eva's birth was really positive for me because I was able to admit that to myself and to choose just this one time not make everything a struggle.

I also want to be clear, though, that I was not passive about this situation, either. There were several decisions I made that I think helped me live with the kids' c-section births. This is where I think many of the childbirth books I read fell short; they spent so much time trying to encourage me to avoid a c-section that they dismissed any discussion of how to improve my experience in having one. I argued to carry Eva fully to term instead of going with the traditional 38 or 39-week delivery common to many planned c-sections. I researched available surgeons and made sure to schedule my delivery on a day the one I liked best was in the OR. Additionally, I fought (and I mean FOUGHT-with both kids) to be allowed to have them with me in the recovery room.

On Eva's birthday, as I think about her birth and come to terms with the idea that we probably won't have any more children, I am just now fully realizing my feelings about this whole situation. I don't want to portray myself as being abused by the natural childbirth community; certainly there are times when I was more a victim of my own self-consciousness than anyone else's condemnation. But I would like to add my birth stories to the dialogue, not as an example of what not to do, and not under the heading of traumatic births, but as an encouragement that even when things don't go as you plan them they can still be satisfying or even beautiful.


  1. dear friend, thank you for sharing your heart. i don't have any experience with birth yet, but i hope to someday and i appreciate your candid words and tender heart toward others. i do think that you're addressing something that is sadly lacking in birthing books and general education right now. God uses you in so many ways. you're a treasure and a part of God's working in my life.

  2. Love your story. There are so many sides to the birthing issue and I do believe that aside from coming away with a healthy baby it is most important to come away with peace in your heart about how decisions were made around your birth experience. Glad you have that (I do too!)

  3. I'm glad you shared your story, and I hope I never made you feel like you weren't part of The Club.

    I remember how you struggled to make the decision for a repeat C. I too advocate the most natural birth possible, unless there are pain meds available, of course.

  4. i personally never understood why there seems to be so much judgement when it comes to childbirth methods, and think that some staunch advocates of purely natural childbirth ignore how many women and children die in natural childbirth, both in the past and now in countries with less access to medical care. i think i too could have easily been seduced into the mindset of natural being the only right way, if my husband had not been a doctor who had seen too many things go wrong. and i have to say now, after one vaginal birth with pitocin and an epidural and one vaginal birth with no medical intervention ( as far as the delivery that is) that if i had not had doctors available my children may not be alive or healthy today. like you, i fully advocate that women who feel compelled to do so strive for fully natural childbirth, but in a setting where medical assistance or intervention are available if needed. i think i would regret trading my child's health for an ideal birth 'experience' infinitely more than getting an epi or a c-section that maybe i could have done without.

  5. To my Beautiful Daughter: I begged for years for grandchildren. Thank you for Daniel and Eva. They are the absolute joys of my life. It has been said that grandchildren are one of God's compensations for growing older. I believe that is true. Every day I thik of their smiling faces and spontaneous laughter and my heart is filled with joy. They bring out the kid in me and remind me to not take life so seriously. God has blessed me and I am thankful to him everyday. You have made my life complete. Mom